scalding and smarting, as he expressed it. This was caused, no doubt, by the abradation of the inner surface of the ure thra. He continued in a similar state for near a fortnight, when the membranous part of the urethra was observed, in the course of one night, to have swelled to near three times its natural size. This remained stationary for some days, when it began to increase rapidly, distending all the base of the scrotum, especially the left side. Its substance, which had continued till now quite relaxed, became also suddenly distended and anasarcous. At this time he did not pass more than two ounces of water in the course of the twenty-four hours. A rupture of the urethra or bladder therefore seemed evident: the size of the scrotum became now immense, and the pain less severe. Warm fomentations had been constantly applied to the pubis and hypogastric region, which gave him more ease than opium, conium miculatum, or other narcotics. He was now harassed with frequent reachings and vomitings, and had no appetite, to which diarrhoea and singultus soon succeeded, and his dissolution appeared fast advancing. As he would not submit to any operation, and for temporary relief, the scrotum was punctured in several places; and water exuded in considerable quantity from this time till his decease, which happened about thirty-six hours after. EXAMINATION OF THE PARTS. About six hours after I obtained, with some difficulty, permission to inspect the diseased parts. The scrotum was so much distended that it covered all the circumjacent parts, not only concealing the perinæum, but extending over the anus, when placed on his back. On applying partial pressure to its surface, the impression remained, for some time, as in other anasarca. An incision was made on the left of the septum scroti, and after passing through near an inch in depth of cellular substance, the scalpel plunged at once into a sac, in withdrawing which, purulent matter, instead of urine, rushed out as from a divided artery. The puncture was enlarged, and in less than two minutes, more than a quart was collected of this apparently well-digested pus. On examining the ure thra, I found that it was not only ruptured from the neck of the bladder to within about three inches of the glans penis, but that corpus spongiosum had, in a great measure, formed the cyst in which the matter was contained; the rupture of which into the scrotum caused, no doubt, its sudden dis tention, tention, which is noticed above. The neck of the bladder was also destroyed, having two or three perforations into it, through which I could easily pass my fingers. I then felt whether there were any calculi, but found none; on the contrary, the bladder itself was contracted to less than half the natural size, and consequently much thickened and on its left side, near the entrance, was found a hard schirihous tumor about the size of a pigeon's egg, but no abscess. The testes were in separate cavities from that in which the matter was contained, and appeared healthy. You will excuse this rough sketch, and be assured of my regret, that prejudice should not have suffered a more mi nute detail. I remain, Sir, with great respect, yours, &c. Ipswich, August 2, 1810. Communicated by DR. Two Cases of the destructive Effects of a foreign Body admitted into the Trachea, &c. KINGLAKE. CALAMITOUS instances are not unfrequently occurring, of substances accidentally escaping into the trachea, and baffling the expulsive efforts of both nature and art, in endeavouring to effect their removal. Within a short time, two distressing cases of this kind have come within my knowledge, occasioned, in both instances, by a small dry bean falling into the trachea. The immediate inconvenience produced by these accidents, was that of insufferable irritation in the trachea, accompanied with anxious and laborious respiration. This state would often proceed to paroxysms of vehement coughing; but these struggles, after exhausting the afflicted patients, hurrying the action of the heart and arteries to a state of tremor, and bathing the surface in cold sweat, would subside, until the recruited powers of life led to a renewal of the convulsive but unavailing effort to detach and expel the offending body. In this unalleviated and hopeless career of affliction both patients survived a few days the recurrence of their respective accidents, when they fell hapless victims to the slow-paced approaches of suffoca tion. The effects of vomiting and coughing, exerted under every advantage of position, where wholly unsuccessful. In dissection, the destructive beans were found in both. cases at the lower part of the trachea, firmly fixed by the enlarged dimensions which they had acquired from vegetative expansion. Thus circumstanced, it was physically impossible to disengage them by any action which the trachea could exert on the obstructing bulk. In similar occurrences, therefore, it becomes both a chirurgical and physiological question of much practical importance to determine, whether it would not be adviscable to endeavour to remove such causes of inevitable destruction, by dividing the trachea sufficiently to admit of a search for such a substance by a suitable instrument, or even by the point of the fore finger. Such an opening would at once afford the operator free access to the extraneous body, and a way by which it may be discharged by natural effort. If the obstructing substance be dislodged from the situation to which inflammatory excitement, (through the medium of effused coagulable lymph), as well as its own enlarged dimensions, may have fettered it, its final removal will be much facilitated. Examples of dividing the trachea in rash attempts at suicide, have been known to occur, in which respiration has, for a time, been carried on through the aperture made in the trachea instead of by the mouth; and afterwards, by gradually and continually closing up the incised opening, the breathing has resumed its natural course. If this can happen under the rudest circumstances of self-violence, it surely may be more commodiously and securely effected by the address and management of surgical skill. Anceps remedium melius quam nullum, should be the justifying maxim on this occasion. Without an attempt to aid in the way proposed, the unhappy subjects of the accident under con sideration must necessarily, in a large proportion, if not uniformly, fall victims to the suffocating difficulties of the case. The practice of opening the trachea in enginal and other obstructions threatening suffocation, is not new. Fabescius ab Aqua pendente, speaks of it in the following terms :"Plures auctores sectionem asperæ arteriæ probarunt, tam antiqui tam recentiones, etenim Abbucasis expressè dixit, quod in sectione asperæ arteriæ non est timor, idque comprobat exemplo ancillæ, quæ, cum aliquando sibi ipsi cultello asperam arteriam præcidisset ipsam sanavit facilè, et sine ullo periculo; sed et recentiones multi, ut Brasavolus, et alii ad ipsum attestantur. Cui opinioni ego li benter benter subscribo." Then describing the mode of making the proposed incision, he says, Inclinato ægroti capite retrorsum, ut arteria reddatur conspicua, addo ego, et ar teria distendatur, et longior fiat et membranosa intermedia, seu interstitia magis appareant, transversa linea incidamus cutem quæ exterius in collo est, inter duos circulos, ita ut membranam secemus, mediam inter cartilaginem ipsam, non cartilaginem; quæ sectio facienda est infra caput asperæ arteriæ, spatio trium ejusdem quatuorve circulerum."-Although the admonition here cited is not expressly given for the extraction of foreign bodies from the tracheal tube, yet its admissibility on such occasions is obviously implied. Indeed those instances would seem more especially to justify incurring whatever hazard may attend the operation, in as far as no disease exists independently of that which is induced by the direct irritation of mechanical pressure, and the exclusion of a due influx of atmospheric air into the lungs. This view of the subject then presents a solemn appeal to the medical world, whether the proposal here suggested should not be early resorted to, in preference to abandoning the afflicted patient to the destructive torments of incessant, painful, and fruitless coughing. Taunton, Sept. 6, 1810. I am, &c. ROBERT KINGLAKE. P. S. Please to notice an erratum in your Number 138, for August, viz. page 109-line 8-for secretions, read accretions. Remarks on the inability to produce the effect of Emetics in Horses. By GEORGE HARGROVE, Member of the Roy. Col. of Surgeons, London; and Assist. Surg. Royal Reg. of Artillery. COMPARATIVE anatomy possesses so many sources, not only of information to those inclined for its reception, but of philosophical amusement to the otherwise indifferent student, that one feels surprized it is not more the order of the day, or at least, that some trifling portion of our time is not more generally devoted to an enquiry into that order of animated nature, which in every step so strongly exhibits our own. wonderful structure; and at the same moment that it inspires us with the most profound reverence, for the magnahimous author of contrivances so truly noble, it imperceptibly leads leads on the reflecting mind to the knowledge of phenomena, still more interesting to our limited conceptions. Ambition for knowledge has, time immemorial, been the great charac teristic of man; and as long as he restrains this inherent principle within reasonable bounds, he only complies with the ordinance of Providence, and by this means, amply enriches his intellectual powers; but the instant he exceeds those limits, he audaciously pries into secrets, which his comprehension does not authorize him to understand, and, from his too ardent, I might add, criminal presumption, he often sacrifices the reasoning faculties he previously possessed, to an inconsiderate zeal after works, that are only familiar to the most exalted genius. Having often heard it argued by literary men, both before and after I entered on the the studies of my profession, that it was impracticable to produce the effect of emetics in horses, even if this description of medicine should be given in the largest quantitics; I determined to let no opportunity pass unnoticed, that would be likely to develope the mys tery, and although the majority of my professional readers may not feel interested in this communication, yet, as there is a chance that some few may be unacquainted with it, especially some of those who are in the habit of perusing this valuable publication, without belonging to the profession, I feel an equal interest in offering it, and can only say, that in addition to the latter circumstance, a zealous desire of dif fusing, even so inconsiderable a portion of physiological observation as this is, are to me sufficient inducements for wishing to see it in print. I lately had two very favorable opportunities of examining the situation, form, and struc ture of the stomach of a horse; one of these animals had been shot in consequence of being affected with glanders, the other with a discase, which this class of beasts appear extremely liable to, lock-jaw. After having the stomach and its appendages, the esophagus, and part of the duodenum, removed from the abdomen, and cleaned, I carefully made an incision on the greater arch, at the part where the duo, denum joins, so that I could with facility introduce my hand without dilating the incision; I now thought to push the index finger of my right hand gently into the cardiac orifice, from the great sac upwards, of course, but to my astonishment, I found it impossible; I refrained from using force, withdrew my hand, and extended the incision to within three inches of the cardia, when I saw the orifice firmly contracted; I now used a little force, and got my finger beyond the stricture, which girt it round with an unusual degree |